Provider Demographics
NPI:1245487248
Name:LEE, JOANNA SHIOW-JUN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:SHIOW-JUN
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SILVERADO ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3200
Mailing Address - Country:US
Mailing Address - Phone:909-263-1036
Mailing Address - Fax:
Practice Address - Street 1:2002 SILVERADO ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3200
Practice Address - Country:US
Practice Address - Phone:909-263-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15912363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical